Saturday, April 24, 2010

My name is Kayla Bronder and I have Jiggers...Kenya Week 29: April 18-April 24

At first I thought it was Poison Ivy. The red, swollen, itchy skin reminded me of my almost yearly encounters with that cursed plant back home. But how could I get Poison Ivy only on the tip of my left big toe and my right second toe? That’s weird. But it really itches. And the skin is pretty red. Hmmm...well whatever it is, I’m sure it will go away in a few days.

A few days later I noticed the tale tell quarter inch wide white halo with a black dot in the center. Right on the end of my toe nail.

No.

Absolutely not.

It can’t be.

I ALWAYS wear closed shoes when I’m out in the community. My house has a nicely tiled floor. And I shower everyday, which always includes a thorough scrubbing of my feet.

That CANNOT actually be a jigger. I would have notice before it got that big!

Turns out I was wrong. It was not only one jigger. But four. Two big ones along my toe nails and two small jiggers attempting to sneak their way into the sides of my toes.

My initial reaction was embarrassment. How could I not have noticed bugs digging into my feet? And why did I convince myself for three full days that it was some strain of Africa poison ivy rather than actually taking a closer look? Maybe I shouldn’t wear my flip flops when I go down for dinner. I don’t want the other volunteers or priests to notice!

Right alongside embarrassment was disgust. Those are living, breathing parasites burrowed inside my toes! THAT IS DISGUSTING. That white halo with the black dot in the center suddenly takes on a whole new meaning when it’s inside your own toe rather than that of a 7 year old boy running around without shoes.

So my toes itch, I’m feeling a bit queasy at the thought of the living insects inside my skin, and I’m totally ashamed that I’ve allowed the very parasites I’m working to eradicate dig into my feet.

Now what do I do?

The first step to overcoming a difficulty is acknowledging your problerm. I’ll break through the social stigma and admit that I have a problem. Here goes...

My name is Kayla Bronder and I have jiggers.

Thankfully in the past seven months I’ve become something of an expert jigger remover. Cutting out the little buggers was quite easy although not entirely painless. While digging away at my feet, I thought to myself how different it is to remove your own jiggers rather than someone else’s. The sharp pain as the razor digs too deep instantly tells me to stop. Whereas the poor children can only cry and pray I don’t do that again. And I realized that the removal of the jiggers is only the beginning. The swelling and itching actually worsens for a few days after the flea is removed as the body heals itself. Rather than being relieved to finally have the jiggers out of their hands and feet, our poor patients go home in even more pain than before.

The good news is that I’m three days post operation and I’m healing well. And as I overcome my embarrassment and disgust, the swelling and itching slowly fade.

The small circular scabs ground me in the humanity behind the parasites I’ve been working to eradicate. Tungiasis is no longer a disease that affects only the poorest of the poor living in mud huts. As the saying goes: If you play with fire, you’ll get burned. Or in my case: If you fight jiggers, they’ll eat your toes.

In a way, I’m thankful for the experience. Before I came to Kenya, I told my mother that I hoped I would get just one, mild case of some tropical disease I had studied in my social work class. Of course that comforted any fears she had about her daughter living half way around the world. But I was thinking maybe a bought of malaria or some general diarrheal disease. Nothing serious, just something to make my whole experience in Africa complete. I’ve been here almost 7 months and I’ve never felt healthier in my life. No malarial fevers, not even occasional nausea. A few jiggers qualify as that mild tropical disease I’d hoped for and I’ve escaped relatively unscathed. So don’t worry Mom.

More importantly, the experience has forced me to reflect on the very real dangers that people face everyday in Africa. My white skin or my American passport does not make me immune to those dangers.
Is it worth it? Absolutely.
Would I do it over again? Without a doubt.
Am I looking forward to returning as soon as possible? Definitely.

But next time I’ll pay closer attention to any mysterious, poison ivy-like itching.

Saturday, April 17, 2010

What’s in a Name?....Kenya Week 28: April 11-April 17

In Luo culture, the naming of a child is an important and yet strangely flexible process. Unlike American parents, Luo parents often wait days or even weeks before naming their baby. And while the first name is a traditionally Christian or “Western” name, the second name usually indicates the time, weather, or conditions of the child’s birth. Finally, the father’s name (in our context, the last name) is often overlooked and only used for official documents.

For example, a little boy born at noon time could be named something like Michael (Christian name) Ochieng (O for a boy, -chieng for “noon time”).

A baby girl born while it is raining could be named Vivianne (Western name) Akoth (A for a girl, -koth for rain)

My Luo name is Adhiambo. A for a girl, -dhiambo because I was born in the late afternoon.

The majority of children are named just along those lines. Don, Tony, Stephan, Joseph, Mercy, Faith, Camilla, Fenny, followed by Oluoch, Oriri, Odhiambo, Akinyi, Apiyo, Adongo, and so on and so forth.

Occasionally parents feel inspired by athletes, musicians, or world leaders and name their children Clinton, Regan, and countless Barak Obamas. Right alongside our great American presidents are their beautiful wives Hillary and Michelle. I haven’t met too many Georges or Lauras, but I try not to read too much into that.

Unfortunately some parents make drastically horrible decisions when it comes to naming their children. My (least) favorites have included Violence, Morphine, and Dotcom. Thankfully for Luo children, they mostly go by their Luo names, so they need not dwell on the cruel miscalculations of their families.

The final interesting realization I’ve come to concerning the Luo child naming process is the powerful flexibility of the whole ordeal. With hundreds of babies born at home each day in impoverished conditions, the practice of Birth Certificates, embroidered baby blankets, Birth Announcements remain foreign oddities. So a baby’s name often evolves and changes until something sticks. With that introduction to the beauty of Baby Naming here in Karungu, I want to introduce you to some of the beautiful babies born in the past months:

Kayla Adhiambo Remember little Rocky from Otati with jiggers? He’s now a big brother, again! Rocky’s mother delivered a tiny baby girl, at home, sometime at the end of February. At the time of this photo, Emily told me the baby’s name was Dotcom Akoth. “Dotcom?” I asked incredulously. I must have misunderstood! “Yes, Dotcom. Like from the internet.” Alright then...Dotcom...Poor thing.

Two weeks ago we followed up with Emily, Rocky, David, and Baby Dotcom. They had moved into a tiny mud hut that was previously the kitchen of a family member. Emily could no longer pay rent on the small home they’d lived in before and was forced to relay on the meager resources of her impoverished family. We had to do something to help. A single mother witih 3 small children in a mud hut will amostly definitely become reinfested with jiggers.

We discussed with the family and agreed to buy the metal roofing materials if the family came together to build the rest of the house. When we arrived on Monday morning with the roofing materials, a smiling Emily handed me her beautiful baby girl, introducing her as Kayla Adhiambo. When I asked what had happened to “Dotcom”, the rest of the family insisted that the baby’s new name is Kayla Adhiambo, as a sign of appreciation for the help.

Two weeks ago I was given chickens. This week, a namesake.

Fayol Ailleo
Steve the nurse and his gorgeous young wife Martha live two doors down from Amanda and me in the staff quarters. The newly married couple joyfully announced to us in November that Martha was pregnant and due sometime in April. Martha smiling told me that if that baby is a girl, she will name her Kayla. Two weeks ago Martha gave birth to a beautiful baby boy. Since Kayla was out of the question, they decided to name him after Amanda. Three day old Baby Ailleo was running quite a high fever and poor Amanda was nervous. But he’s doing well now and Martha, Steve, and Baby Ailleo are back home and happy!

Amanda and I laughed and rejoiced at the honor of both having babies named after us the same exact week!

Phanis Kayla Okoth
Lillian is a Voluntary Counseling and Testing (VCT) Counselor at St. Camillus. People come to her to find out their HIV status, so she spends her days restoring hope and reassuring devastated patients. When I first met her in October I thought she looked pregnant. But I didn’t want to be rude, so I didn’t ask. So when the other nurses started joking with her that she looked pregnant, I was reassured. But Lillian stubbornly refused to admit she was pregnant for 3 more months, until it was undeniable. When she finally accepted that she was having her fifth baby, after years of not having a child, she jokingly told me she hopes it’s a girl so she can name her Kayla.

On April 10, 2010 Baby Kayla came into the world. Yes, within one week, there are now three Kaylas in Kenya.

Jerry Edward
Titus Okoth is an exemplary Community Health Volunteer in Otati. The bright, hard working 28 year old consistently goes above and beyond his duties as a volunteer to help mobilize the community and assist the most needy families. He’s well spoken, always smiling, and happy to be an integral part of improving his community. And he works tirelessly without any pay, in the afternoons after he’s tended his fields. It’s been a pleasure working with Titus throughout the project.

Titus’s beautiful wife gave birth to a big baby boy March 25, 2010. The proud father introduced me to his family this week and asked me if they could name their son after my father. I honestly did not believe him at first.

You want to do what? You really want to name your son after my father?
No, Kayla really can’t be a boy’s name.
(And I already had two baby girls named after me this week.)
Well, it is my father’s 50th birthday this week, so the timing is perfect. And my father never had a son to carry on his name, so I’m honored! My father would be proud!
His name is Gerald Edward, but everyone calls him Jerry.


The rest of the afternoon, I proudly carried Baby Jerry in my arms. Happy Birthday Dad!

Thursday, April 15, 2010

So Much To Do, So Little Time...Kenya Week 27: April 4-April 10

My apologies for delaying Week 27’s Blog! I’m five days past due, but for the first time in Kenya, I’ve been too busy to even think about writing. What a blessing! So to commemorate this wonderful occasion, I’ll share with you exactly what’s keeping me so busy! The spare moments I’ve managed to stay in the office, I’ve written a comprehensive workplan January-May, 2010. I’ve caught up on many of my reports, data analysis, and Activity Indicators. They may seem like boring paperwork, but they represent the depth and bredth of the work we’ve accomplished in just a few short months!!

Enjoy!

Nyatike Jigger Eradication Campaign Work Plan 2010

Monday, January 4: Meeting with Otati Sublocation Community Health Volunteers to organize mobilization and spraying for Otati Jigger Eradication Campaign (used MOH motor bike)
Tuesday, January 5: Purchase Otati Campaign supplies in Kisii (used public transportation)
Wednesday, January 6: Reports, Budget
Thursday, January 7: Organize for Otati Jigger Removal Day
Friday, January 8: Otati Jigger Removal Day I (used SCMH and MOH vehicle)

Monday, January 11: Severe Cases report to SCMH, treat Zadox Ouko, Brian Odhiambo, David Otieno, Eunice Juma and 4 children
Tuesday, January 12: Home Visit and Needs Assessment with Eunice Juma and David Otieno, organize cementing and smearing of homes
Wednesday, January 13: Otati Jigger Removal Day II (used SCMH and MOH vehicle)
Thursday, January 14: Reports
Friday, January 15: Kisumu

Monday, January 18: Organizing for fundraising/publicity
Tuesday, January 19: Reports, Research, Meet with Tom Odhong to discuss Project
Wednesday, January 20: Reports, Preparations for Rabare
Thursday, January 21: Rabare Primary Removal Day (used SCMH and MOH vehicle)
Friday, January 22: Organizing for fundraising/publicity

Monday, January 25: Reports, Research
Tuesday, January 26: Reports, Budget
Wednesday, January 27: Research, Follow up with Wambogo Family
Thursday, January 28: Organizing for fundraising
Friday, January 29: Follow up Eunice Juma and family and David Otieno. Organize for nutritional support for David Otieno

Monday, February 1- Friday, February 25: Travel and Fundraising in the United States

Monday, March 1: Follow up Juma family, David Otieno
Tuesday, March 2: Meeting with NJEC Stakeholders at SCMH
Wednesday, March 3: Reports
Thursday, March 4: Home visit Wambogo Family
Friday, March 5: Home visit Wilson and Jackline, Follow up Otati Dispensary and Otati Primary School

Monday, March 8, 2010: Return from Nairobi
Tuesday, March 9: Meeting in McAlder- Nyatike District Headquarters with MOH Public Health Officers concerning Collaboration, Organization, and Way Forward for Nyatike Jigger Eradication Campaign
Wednesday, March 10: Roof Construction for Wilson and Jackline in Otati
Thursday, March 11: Reports, Organizing for CHV Training
Friday, March 12: Reports, Meeting with Tom Odhong to plan for CHV Training

Monday, March 15: NJEC Community Health Volunteer Training I: Gunga, Sori, Otati, and Raga Subdivisions. At Karen Zwickert Children’s Home.
Tuesday, March 16: Home visit and Needs Assessment with CHV Richard Oongo: Misiwi Sublocation: Priscilla Ariri, Eleseba and Samson, Rosa Anyango, Arrange for treatment at SCMH and smearing all three homes
Jigger Removal for Rose Anyango in her home
Wednesday, March 17: Nyora Beads Project, Reports
Thursday, March 18: Bring Priscilla Ariri, Elseba, and Samson to SCMH, begin jigger removal and treatment (used SCMH vehicle)
Friday, March 19: NJEC Community Health Volunteer Training II: Misiwi, Okayo, Alendo, and Ngira Subdivisions. At Karen Zwickert Children’s Home.

Monday, March 22: Write Training Reports
Tuesday, March 23: Jigger Removal for Priscilla, and Nyora Beads Project
Wednesday, March 24: Be the Change Vacations and Karen Zwickert Children’s Home Project
Thursday, March 25: Jigger Removal for Priscilla, Reports
Friday, March 26: Morning: Data Analysis, Afternoon: Wachara Removal Day

Monday, March 29: Morning: Reports, budget
Afternoon: Purchase supplies and return Priscilla Ariri home (used SCMH vehicle)
Follow up with Elseba and Samson
Tuesday, March 30: Reports, organize Removal Day work plan with Tom Odhong
Wednesday, March 31: Needs Assessment Otati Primary School and Rabare Primary School
Follow ups in Otati Sublocation: Wilson and Jackline (used SCMH vehicle)
Meet with Tom Odhong to organize Removal Days
Thursday, April 1: Reports, Analyze Data, Organize for next week
Friday, April 2: Public Holiday

Monday, April 5: Public Holiday
Tuesday, April 6: Cementing Otati Primary and Rabare Primary (used SCMH vehicle)
Wednesday, April 7: Reports
Thursday, April 8: Riat Dispensary Removal Day (used SCMH vehicle)
Friday, April 9: Severe Case removal in SCMH: Regan Owino and Eric Odhiambo

Monday, April 12: Roof Construction in Otati: Emily, Rocky, David, Kayla Adhiambo.
Follow up: Otati Primary, Rabare Primary, Wilson and Jackline. Community meeting with Not Primary board and parents (used SCMH vehicle) Needs Assessment in Otati: Owidhi, John Ogalo and family. Needs Assesment in Not: Thadayo Odongo and family, Daniel Konje and family Tuesday, April 13: Meeting with Tom Odhong to complete April and May Work Plan, Work on Reports, visit admitted patient with jiggers
Wednesday, April 14: Morning: Reports, Establish May and June work plan train Medical 2 nurses on Jigger Removal
Afternoon: Visit severe cases in Okayo (need transport, can take motor bike)
Thursday, April 15: Morning: Purchase materials for Roof Construction: Ogalo family, Follow up with David Otieno, organize for completion of smearing
Afternoon: Write reports, settle budget
Friday, April 16: Morning: Reports, Budget
Afternoon: Follow up completed projects: Otati Primary, Rabare Primary, Emily Roof, Ogalo Roof (need transport, can take motor bike), Needs assessment at Wangara Primary School

Monday, April 19: Not Primary School Cementing Project
Tuesday, April 20: Obware Removal Day (Need SCMH vehicle)
Wednesday, April 21: Riat Dispensary Removal Day II (Need MOH vehicle)
Thursday, April 22: Roofing at Okayo: Julius Ojwang/Rose Atieno/Colleta Adhiambo, and Hellena Omolo
Friday, April 23:

Monday, April 26:
Tuesday, April 27: Raga Primary School Removal Day (Need MOH vehicle)
Wednesday, April 28: Aringo Primary School Removal Day (Need SCMH vehicle)
Thursday, April 29: Roofing at Not: Thadayo Odongo/Mary Anyango and Daniel Konje/Anna Chieng
Friday, April 30:

Monday, May 3: Alendo Primary School Removal Day (need SCMH vehicle)
Tuesday, May 4: Otati Dispensary (Need MOH vehicle)
Wednesday, May 5: Bronder in Nairobi.
Thursday, May 6: Nairobi
Friday, May 7: Nairobi

Monday, May 10:
Tuesday, May 11: Obondi Primary Removal Day (Need MOH vehicle)
Wednesday, May 12: Not Primary (Need SCMH vehicle)- tentative depending on status of cementing the school.
Thursday, May 13:
Friday, May 14:

Monday, May 17: Ratanga Removal Day (Need SCMH vehicle)
Tuesday, May 18:
Wednesday, May 19: Follow up with Elseba and Samson, Priscilla, and Wambogo family
Thursday, May 20: Meeting with NJEC Stakeholders at SCMH- draw comprehensive Work Plan for June-December 2010, organize Management Structure and Way Forward with Liz as new coordinator
Friday, May 21: Kayla’s last day in Karungu, Maternity Wing Inauguration

Wednesday, April 7, 2010

Two Chickens in One Week: We Must Be Doing Something Right!...Kenya Week 26: March 29-April 4

As we celebrate Holy Week, I can’t help but smile when I think about the gifts we’ve given and the gifts we’ve received this week. By Holy Thursday, Priscilla, Elseba, Samson, Wilson, and Jackline were resting comfortably in their jigger free homes. Otati Primary School and Rabare Primary School were working hard to prepare the floors of their classrooms for cementing. We had all the data collected and we’re making a schedule for the upcoming Jigger Removal Days. And we made an “Informational and Educational Communication” piece, i.e. a small flyer about how to treat and prevent jiggers.

Even more exciting than seeing the project really come together despite bad weather and worse roads is seeing the appreciation and relief in the eyes of the people we help. When Priscilla’s nephew walked up to the home holding a squawking chicken, I thought he was giving it to Priscilla for a welcome home gift. But when he thrust it towards me, wings flapping and feet kicking, I realized he wanted me to accept his feathery display of gratitude. Luckily Richard the Community Health Worker recognized my hesitation and intercepted the bird. We express our gratitude for the gift, and then passed it on to Priscilla. She needs the protein more than we do. As we drove away, the family smiled and waved as Priscilla held the chicken in her lap. Maybe she’ll have a few eggs to eat for Easter.

Two days later we visited Wilson and Jackline to see how the construction of their home was coming along. They’d faced some difficulty with the rains and the floor of their home was more of a mud pit than a floor. But we organized for the work to continue and the community promised to help Wilson finish the walls and floor. As we prepared to leave, Wilson snuck away. A moment later he came back carrying a chicken and a huge smile on his face. As with Priscilla, I tried to say, “thanks but no thanks”. But Wilson would have none of it. Although he only has 4 chickens, he insisted that I take one as a sign of his appreciation for helping him complete his new home.

Although I’m quite sure the chicken-Easter Egg connection was lost on the Kenyans, I chuckled to myself at the thought of receiving two chickens the week before Easter. For all the times I’ve felt discouraged or useless here in Kenya, the chickens remind me that we really are doing something right.

I carried the chicken down to the kitchen and proudly handed it to Dominic the cook. The questioning look on his face revealed his suspicion of how and why I was handing him a live chicken. When I told him about Wilson, he smiled approvingly and went into the kitchen for the knife.